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General NPI Number Information
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NPI Number | 1285729871
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Entity Type | Individual
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Provider Name | AGOSTINHO M. OLIVEIRA D.C.
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Gender | Male
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Dates
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Enumeration Date | 10/03/2006
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Last Update Date | 05/15/2009
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Provider Practice Location Address
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Address Line | 163 HAMPTON POINT DR SUITE 4
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City | ST AUGUSTINE
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State | FL
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Zip | 32092-3059
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Country | US
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Telephone | 904-230-2717
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Fax | 904-230-2720
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Provider Business Mailing Address
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Address Line | 163 HAMPTON POINT DR SUITE 4
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City | ST AUGUSTINE
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State | FL
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Zip | 32092-3059
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Country | US
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Telephone | 904-230-2717
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Fax | 904-230-2720
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 111N00000X
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Taxonomy Name | Chiropractor
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License Number | CH9245
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License Number State | FL
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Taxonomy #2
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Taxonomy Code | 111N00000X
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Taxonomy Name | Chiropractor
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License Number | X008831-1
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License Number State | NY
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Taxonomy #3
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Taxonomy Code | 111N00000X
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Taxonomy Name | Chiropractor
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License Number | 0104555764
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License Number State | VA
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